Provider Demographics
NPI:1629196613
Name:O'CONNOR, P. ANN X (PHD)
Entity Type:Individual
Prefix:
First Name:P.
Middle Name:ANN
Last Name:O'CONNOR
Suffix:X
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:ANN
Other - Last Name:O'CONNOR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:9041 STRAW FLOWER DR
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922-5961
Mailing Address - Country:US
Mailing Address - Phone:865-607-1329
Mailing Address - Fax:
Practice Address - Street 1:11704 KINGSTON PIKE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37934-3827
Practice Address - Country:US
Practice Address - Phone:865-966-9791
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1591103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling